# Asymmetric Lip Hyperpigmentation in a Transplant Patient

## TL;DR

A transplant patient developed uneven dark spots on her lower lip, possibly linked to lip fillers and long-term medication.

## Contribution

This case report highlights a unique instance of asymmetric lip hyperpigmentation in a transplant patient.

## Key findings

- The patient had asymmetric hyperpigmentation on her lower lip.
- Histology showed epidermal melanosis and HA deposits without melanocytic hyperplasia.
- No granulomatous inflammation was observed.

## Abstract

A 56-year-old patient presented to our dermatology clinic with asymmetric hyperpigmentation on her lower lip, which had developed over the previous six to twelve months. Her medical history included kidney and pancreas transplants, requiring chronic immunosuppression, and two lip filler injections with hyaluronic acid (HA). Clinical examination revealed irregular pigmented macules limited strictly to the lower lip. Histological analysis showed epidermal melanosis, pigmentary incontinence, solar elastosis, and amorphous dermal HA deposits, without evidence of melanocytic hyperplasia or granulomatous inflammation.